TY - JOUR
T1 - Comparisons of the risk of medication noncompliance and suicidal behavior among patients with depressive disorders using different monotherapy antidepressants in Taiwan
T2 - A nationwide population-based retrospective cohort study
AU - Su, Kuan Pin
AU - Lu, Ning
AU - Tang, Chao Hsiun
AU - Chiu, Wei Che
AU - Chang, Hui Chih
AU - Huang, Kuo Cherh
N1 - Copyright © 2019 Elsevier B.V. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Background: The aim of this study was to assess the association between various classes of antidepressants and the risk of medication noncompliance as well as suicidal behavior among depressed patients. Methods: A retrospective cohort study was conducted utilizing two nationwide population-based datasets in Taiwan from 2010 to 2016. The outcome measures included the risk of medication noncompliance, attempted suicide, and completed suicide. Cox proportional hazards models with stratification of the propensity score deciles were performed. Results: A total of 447,411 new antidepressant users were identified. Compared to SSRIs, patients who received SARIs [adjusted hazard ratio (aHR) = 1.124, 95% confidence interval (CI) = 1.108–1.142], SNRIs (aHR = 1.049, 95% CI = 1.033–1.065), and other classes of antidepressants (aHR = 1.037, 95% CI = 1.024–1.051) were more likely to exhibit poor medication noncompliance. Patients who received SNRIs had a higher risk of attempted suicide (aHR = 1.294, 95% CI = 1.114–1.513), compared to SSRIs. However, patents in the TCAs group revealed the opposite result (aHR = 0.543, 95% CI = 0.387–0.762). Concerning the risk of completed suicide, this analysis detected no statistical significance across different types of antidepressants. Limitations: Although the universal coverage of Taiwan's national health insurance program tends to minimize the risk of selection and recall bias, it is difficult to rule out medical surveillance bias by using claim data. Conclusions: This study demonstrated that classes of antidepressants exert different degrees of impact on the risk of medication noncompliance and attempted suicide, but not completed suicide, among depressed patients.
AB - Background: The aim of this study was to assess the association between various classes of antidepressants and the risk of medication noncompliance as well as suicidal behavior among depressed patients. Methods: A retrospective cohort study was conducted utilizing two nationwide population-based datasets in Taiwan from 2010 to 2016. The outcome measures included the risk of medication noncompliance, attempted suicide, and completed suicide. Cox proportional hazards models with stratification of the propensity score deciles were performed. Results: A total of 447,411 new antidepressant users were identified. Compared to SSRIs, patients who received SARIs [adjusted hazard ratio (aHR) = 1.124, 95% confidence interval (CI) = 1.108–1.142], SNRIs (aHR = 1.049, 95% CI = 1.033–1.065), and other classes of antidepressants (aHR = 1.037, 95% CI = 1.024–1.051) were more likely to exhibit poor medication noncompliance. Patients who received SNRIs had a higher risk of attempted suicide (aHR = 1.294, 95% CI = 1.114–1.513), compared to SSRIs. However, patents in the TCAs group revealed the opposite result (aHR = 0.543, 95% CI = 0.387–0.762). Concerning the risk of completed suicide, this analysis detected no statistical significance across different types of antidepressants. Limitations: Although the universal coverage of Taiwan's national health insurance program tends to minimize the risk of selection and recall bias, it is difficult to rule out medical surveillance bias by using claim data. Conclusions: This study demonstrated that classes of antidepressants exert different degrees of impact on the risk of medication noncompliance and attempted suicide, but not completed suicide, among depressed patients.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Antidepressive Agents/therapeutic use
KW - Cohort Studies
KW - Depressive Disorder/drug therapy
KW - Female
KW - Humans
KW - Male
KW - Medication Adherence/psychology
KW - Middle Aged
KW - Retrospective Studies
KW - Risk Assessment
KW - Suicidal Ideation
KW - Suicide, Attempted/psychology
KW - Taiwan
KW - Young Adult
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U2 - 10.1016/j.jad.2019.03.039
DO - 10.1016/j.jad.2019.03.039
M3 - Article
C2 - 30856494
AN - SCOPUS:85062446516
SN - 0165-0327
VL - 250
SP - 170
EP - 177
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -